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General NPI Number Information
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NPI Number | 1801309190
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Entity Type | Individual
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Provider Name | MS. CAROLYN LOUISE HANSEN
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Gender | Female
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Dates
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Enumeration Date | 11/09/2017
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Last Update Date | 01/19/2026
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Provider Practice Location Address
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Address Line | 3407 GLENVIEW AVE
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City | AUSTIN
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State | TX
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Zip | 78703-1448
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Country | US
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Telephone | 512-387-8349
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Fax |
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Provider Business Mailing Address
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Address Line | 1313 E 52ND ST APT 103
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City | AUSTIN
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State | TX
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Zip | 78723-3001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA11549
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2088F0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
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License Number | PA11549
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License Number State | TX
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